Impact Of High-density Lipoprotein Cholesterol Research Articles

Association between high-density lipoprotein and functional outcome of ischemic stroke patients in a Taiwanese population

Despite recent findings indicating a paradoxical association between high-density lipoprotein cholesterol (HDL-C) levels and cardiovascular disease (CVD) mortality, the impact of HDL-C on subsequent outcomes after ischemic stroke remains unclear. The study aims to investigate the relationships between HDL-C levels and post-stroke functional outcomes while examining the potential modifying influence of HDL-C-related single nucleotide polymorphisms identified through genome-wide association studies. This cohort study included 1,310 patients diagnosed with acute ischemic stroke (AIS), all of whom had their admission serum lipid profile and genotyping information. Participants were categorized into four groups based on gender and HDL-C level. Prognostic outcomes were assessed using a modified Rankin Scale (mRS) at 1, 3, and 12 months post-admission. Multivariate logistic regression and restricted cubic spline regression analysis were used to assess the associations between HDL-C levels and outcomes. The mean age of patients was 61.17 ± 12.08 years, and 69.31% were men. After adjusting confounders, patients with the highest HDL-C level group had a significantly higher risk of poor functional outcomes at 1, 3, and 12 months following stroke compared to the reference group. Restricted cubic splines depicted a nonlinear association between HDL-C levels and poor prognosis in both men and women. The ABCA1 gene rs2575876 AA genotype combined with abnormal HDL-C levels exhibited a significantly heightened risk of post-stroke adverse outcomes at 1 and 3 months compared to patients with normal HDL-C levels and GG + GA genotype. These findings suggest that the combined effects of ABCA1 genetic variants with either low or high HDL-C levels could further heighten this risk.

Potential impact of high-density lipoprotein cholesterol in the postoperative outcomes of chronic subdural hematoma patients: multi-institutional study in Korea

BackgroundChronic subdural hematoma (CSDH) is a common clinical situation in neurosurgical practice, but the optimal treatment option is controversial. This study aimed to evaluate the effect of cholesterol-lowering medications on and how they affected the prognoses of CSDH patients.MethodsIn this multi-institutional observational study performed in Korea, data from recently treated CSDH patients were gathered from 5 hospitals. A total of 462 patients were collected from March 2010 to June 2021. Patient clinical characteristics, history of underlying diseases and their treatments, radiologic features, and surgical outcomes were analyzed.ResultsSeventy-five patients experienced recurrences, and 62 had reoperations after the initial burr hole surgery. Among these, 15 patients with recurrences and 12 with reoperations were taking cholesterol-lowering medications. However, the use of medications did not significantly affect recurrence or reoperation rates (P = 0.350, P = 0.336, respectively). When analyzed by type of medication, no clinically relevant differences in total cholesterol (TC), triglyceride (TG), or low-density lipoprotein cholesterol (LDL-C) levels were identified. The combination of a statin drug and ezetimibe significantly elevated high-density lipoprotein cholesterol (HDL-C) levels (P = 0.004). TC, LDL-C, and TG levels did not significantly affect patient prognoses. However, HDL-C levels and recurrence (odds ratio (OR) = 0.96; 95% confidence interval (CI): 0.94–0.99; p = 0.010) were negatively correlated. An HDL-C level of 42.50 mg/dL was identified as the threshold for recurrence and reoperation.ConclusionsIn this study, using cholesterol-lowering medications did not significantly impact the prognosis of patients who underwent surgical management for a chronic subdural hematoma. However, the findings showed that the higher the HDL-C level, the lower the probability of recurrence and reoperation.

Impact of low early high-density lipoprotein cholesterol on inhospital outcome and short-term prognosis in patients with acute coronary syndrome

Background: Acute coronary syndrome (ACS) is a cardiac emergency and constitutes a major burden globally. Association between serum lipid and ACS is established many years ago. Our study tried to have more information about the impact of high-density lipoprotein cholesterol (HDL-C) on inhospital outcome and short-term prognosis of patients with ACS. Materials and Methods: The study was a prospective comparative study. Clinical and chemical and interventional evaluation was done in hospital settings. A total number of 50 patients were included in the study and divided into two groups. Patients with low HDL-C level were in Group I and patients with normal HDL-C were in Group II. Results: Group I populations had more inhospital complications than Group II represented in acute heart failure (48% vs. 13%), cardiogenic shock (40% vs. 6%), complex coronary lesions (57% vs. 20%), and prolonged hospital stay (54% vs. 20%). A statistical significance was found regarding these variables (P

Study of High Density Lipoprotein Cholesterol among Patients with Acute Coronary Syndrome in Sohag niversity Hospital

Objective: To estimate the prevalence, and impact of high-density lipoprotein cholesterol (HDL-C) on in-hospital outcomes among acute coronary syndrome (ACS) patients in Sohag University Hospital. Methods: Data were collected prospectively from 273 consecutive patients admitted with a diagnosis of ACS. A low HDL-C was defined as a level <40 mg/dL (1.0 mmol/L) for males and <50 mg/dL (1.3 mmol/L) for females and satisfactory HDL-C is defined as a level ≥40mg/dl for males and ≥50mg/dl for females. Results: The overall mean age of the study patients was 58.9_+11.3 years and majority was males (51.4%). The overall prevalence of low HDL-C was 73.3% and satisfactory HDL-C was 26.7%. During in-hospital stay and at discharge, the majority were on statin therapy (83.2%) while 7.7% were on fibrates. Low HDL-C patients were associated with higher in-hospital mortality than satisfactory HDL-C patients (12% vs. 11%; p=0.012) and higher CHF (18% vs.5.5%; p=0.01). Conclusion: ACS patients in Sohag governorate in upper Egypt have a high prevalence of low HDL-C. Insignificantly higher in-hospital mortality and CHF were associated with low HDL-C in women but not in men.

Impact of High-Density Lipoprotein Cholesterol on Revascularization Procedures in Patients With Stable Ischemic Heart Disease: From the COURAGE trial*

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Low high-density lipoprotein cholesterol is a residual risk factor associated with long-term clinical outcomes in diabetic patients with stable coronary artery disease who achieve optimal control of low-density lipoprotein cholesterol

Diabetes mellitus is recognized an independent risk factor for coronary artery disease (CAD) and mortality. Clinical trials have shown that statins significantly reduce cardiovascular events in diabetic patients. However, residual cardiovascular risk persists despite the achievement of target low-density lipoprotein cholesterol (LDL-C) levels with statin. High-density lipoprotein cholesterol (HDL-C) is an established coronary risk factor that is independent of LDL-C levels. We evaluated the impact of HDL-C on long-term mortality in diabetic patients with stable CAD who achieved optimal LDL-C. We enrolled 438 consecutive diabetic patients who were scheduled for percutaneous coronary intervention between 2004 and 2007 at our institution. We identified 165 patients who achieved target LDL-C <100 mg/dl. Patients were stratified into two groups according to HDL-C levels (low HDL-C group, baseline HDL-C <40 mg/dl; high HDL-C group, ≥40 mg/dl). Major adverse cardiac events (MACE) that included all-cause death, acute coronary syndrome, and target lesion revascularization were evaluated between the two groups. The median follow-up period was 946 days. The rate of MACE was significantly higher in diabetic patients with low-HDL-C who achieved optimal LDL-C (6.9 vs 17.9 %, log-rank P = 0.030). Multivariate Cox regression analysis showed that HDL-C is significantly associated with clinical outcomes (adjusted hazard ratio for MACE 1.33, 95 % confidence interval 1.01-1.75, P = 0.042). Low HDL-C is a residual risk factor that is significantly associated with long-term clinical outcomes among diabetic patients with stable CAD who achieve optimal LDL-C levels.

Fractalkine – a local inflammatory marker aggravating platelet activation at the vulnerable plaque

Chemokines play an important role in inducing chemotaxis of cells, piloting white blood cells in immune surveillance and are crucial parts in the development and progression of atherosclerosis. Platelets are mandatory players in the initiation of atherosclerotic lesion formation and are susceptible targets for and producers of chemokines. Several chemokine receptors on platelets have been described previously, amongst them CX(3)CR1, the receptor for fractalkine. The unique chemokine fractalkine (CX(3)CR1, FKN) exists as a soluble as well as a membrane-anchored glycoprotein. Its essential role in the formation of atherosclerotic lesions and atherosclerosis progression has been impressively described in mouse models. Moreover, fractalkine induces platelet activation and adhesion via a functional fractalkine receptor (CX(3)CR1) expressed on the platelet surface. Platelet activation via the FKN/CX(3)CR1-axis triggers leukocyte adhesion to activated endothelium, and fractalkine-induced platelet P-selectin is mandatory for leukocyte recruitment under arterial flow conditions. This review summarises the role of fractalkine as a potential local inflammatory mediator which influences platelet activation in the setting of atherosclerosis. Beyond that, aspects of a potential interaction between fractalkine and platelet responsiveness to antiplatelet drugs are described. Furthermore, the possible impact of high-density lipoprotein cholesterol (HDL-C) on atherosclerosis progression, platelet activation and fractalkine signalling are discussed.